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Medicines > classes : Classic Psychedelic or Dissociative or [[:Category:Trace_elements|Trace element]]

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generic:
brand:
None (86) · Delysid (historical, Sandoz, withdrawn 1965) (1) · DXM (1) · DXO (1) · Many; topical professional/OTC and Rx oral (1) · Spravato (1)
classes: (Click arrow to add another value)
mechanism:
5-HT2A agonist (26) · Potent 5-HT2A agonist (5) · LSD analogue; 5-HT2A agonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · NMDA antagonist (3) · None (2) · Contains LSA (2) · Contains mescaline (2) · NMDA antagonist; sigma receptor agonist (2)
uses:
None (89) · Treatment-resistant depression (TRD) in adults, as adjunct to oral antidepressant (FDA-approved March 2019). Depressive symptoms in adults with MDD with acute suicidal ideation or behavior (FDA-approved Aug 2020). (1) · '"`UNIQ--vote-0000131A-QINU`"', '"`UNIQ--vote-0000131B-QINU`"' (1)
starting dose:
None (89) · Induction (TRD): 56 mg intranasal twice weekly × 4 weeks. Maintenance: 56-84 mg once weekly × 4 weeks, then 56-84 mg every 1-2 weeks. For acute suicidality: 84 mg twice weekly × 4 weeks. Administered under medical supervision in REMS-certified site. (1) · OTC dentifrice/rinse 0.05-0.5% fluoride daily; Rx 1.1% sodium fluoride toothpaste/gel daily; supplements (where local water non-fluoridated) age-titrated 0.25-1 mg/d (1)
preparations:
None (89) · 28 mg/device (each dose uses 2 devices) (1) · Toothpaste, rinse, gel, varnish (topical); 0.25, 0.5, 1 mg tablets and drops (Rx supplements where appropriate) (1)
fda max:
None (89) · 84 mg per session (1) · Topical: per formulation; oral supplement age-dependent (1)
routes:
None (88) · Intranasal (under direct medical supervision) (1) · Oral (2) · Topical (1)
onset:
None (88) · 30–60 minutes (1) · Caries reduction over months to years of consistent use (1) · Within hours of first administration (1)
duration:
None (88) · 8–12 hours (1) · Acute effect ~24 hours; cumulative effect builds with repeated dosing (1) · Hours per topical application (1)
halflife:
None (88) · 3–5 hours (1) · ~6 hours plasma; long bone retention (1) · ~7-12 hours (1)
bioavailability:
None (88) · 70–90% (oral) (1) · Topical: local effect on enamel; systemic supplementation has high oral bioavailability with skeletal accumulation (1) · ~48% intranasal (1)
pregnancy:
None (88) · Avoid; may cause fetal harm (1) · Not established (1) · Safe at routine fluoride levels.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (88) · OTC (most dentifrice and rinse) and [[USLegal:Prescription only|Rx-only]] (high-concentration paste/gel, supplements) in US (1) · Rx, Schedule III (US). REMS program required. (1) · Schedule I (United States) (1)

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